Rapid spread of TB, AIDS discussed by World Health Assembly.

• Position: Includes brief updates on health improvement developments - United Nations developments

The rapid worldwide spread of diseases, such as tuberculosis (TB) and acquired immune deficiency syndrome (AIDS) was a focus of discussions at the forty-sixth World Health Assembly (Geneva, 3-14 May). Plans of the World Health Organization (WHO) to fight health scourges, old and new, were outlined in resolutions adopted by the Assembly.

A new Global Strategy for Health and Environment, an outcome of "Agenda 21" - the action programme adopted at the 1992 Earth Summit in Rio de Janeiro - was endorsed. it warned that sustainable development was possible only when special attention was given to health and environment-related matters. WHO was asked to carry out prospective studies on potential environmental hazards to human health.

New social covenant

There is a growing inequality between countries and between population groups within countries as far as the state of health is concerned, said Dr. Hiroshi Nakajima, reelected by the Assembly as WHO Director-General for a second five-year term.

With a new partnership "between WHO and its Member States, among Member States, between North and South", he said, WHO could reach the "fulfilment of its constitutional mandate and moral mission: the building of universal peace through health for all". It meant, he said, "a new social covenant, a new international bargain". No single entity "can do the job alone".

A reform process at WHO, begun in 1991, would intensify, he predicted. "Together we can herald a world in which health is an unquestioned fundamental human right. We must fight with the peaceful but potent weapons of care, compassion, mutual respect and education."

WHO's annual report on the state of the world's health was the basis of much of the Assembly's debate.

In what was called an extraordinary step, WHO on 26 April declared tuberculosis a global emergency and warned that it would claim 30 million lives over the next decade unless urgent steps were taken to curb it.

"Tuberculosis is humanity's greatest killer and it is out of control in many parts of the world", said Dr. Arata Kochi, Manager of the WHO Tuberculosis Programme. "The disease, preventable and treatable, has been grossly neglected and no country is immune to it."

The Assembly requested a study on establishing a worldwide UN programme on human immunodeficiency virus (HIV) and AIDS, identifying four areas for particular attention:

* anticipated growth and consequences of the pandemic over the next two decades;

*...